Team EASY: advocacy project - Institute for Healthcare Improvement

IHI Open School
Quality Improvement/Patient Safety
The IHI Student Consortium
IHI Open School
The Quality Project
Presented by the IHI Student Consortium
The Quality Project is a collaboration among
preclinical and clinical students, residents,
fellows, faculty, and administrators across
Stanford. Our mission is to develop higher
quality healthcare that is more safe, effective,
patient-centered, timely, efficient, and
equitable through education, research,
advocacy, and implementation.
IHI Open School
IHI Student Consortium
Education
Research
Advocacy
Implementation
IHI Open School
Education
Research
Advocacy
Implementation
- Leadership Course
- QI Lecture Series
- QI Clinical Elective
- QI in Q6
- Med-Scholars
- Internal Medicine Program
- Hand Hygiene Project
- Leadership Training in Medicine
- Global Safe Surgery Mentor Project
- Patient-Centered Care in Fellowship
- CBEI & Quality
- Team Easy
- Hospital Management Collaborative
- Hand Hygiene: Implementation
- Pacific Free Clinic Quality Initiative
IHI Open School
Medical Leadership
Development
Matthew Goldstein, SMS VI
Robin Eisenhut, SMS III
Barnard Palmer, MD
Tiffany Castillo, SMS V
IHI Open School
Leadership Training in Medicine

Initiated in 2008
PEDS 201: 1 unit, Fall Quarter
Course Director: Charles Prober
Facilitator: Julia Tussing


Students:

Received 40 applications for 8 medical student spots

8 Medical Students (Years 1-3)

4 Chief Residents (Medicine, Surgery, Pediatrics, Psychiatry)
Topics:

What is Leadership?

Self-Knowledge

Communication & Emotional Intelligence

Conflict Management

Influence

Effective Teams
IHI Open School
…encourage everyone to speak their mind
**
…ask you to take positions that support
your core values
*
…seek feedback to improve interactions
with others
**
P = 0.0038
…show that I understand how specific
actions impact others
*
P = 0.030
I am capable of giving constructive feedback
*
P = 0.030
I have a deep understanding of my strengths,
weaknesses, needs, and drives.
*
P = 0.0465
I am honest with myself.
*
P = 0.030
I undertake realistic self-assessment.
**
P = 0.0082
P = .0082
P = 0.030
As a leader I…
Conflict
Management
Self-Awareness
IHI Open School
Testamonial:
Would you recommend the MLD course to others? Do you believe leadership
skills should be taught to medical professionals?
“Yes and yes. I believe leadership skills are learned, and for those who have access to
those skills it is a great benefit. As someone who does not have family in the medical field,
it was invaluable to hear the stories of some leaders in the field and reflect on and discuss
many aspects of leadership that will serve me well as I progress through training and in
shaping my career.”
“Yes, and YES! Simply talking about it prompts reflection, and makes each of us better
leaders. This course coincided with a lot of challenging situations in my own
academic/work life, and it was a great compliment to my own personal development since
it forced me to take some time and just think. I also think it is important for students to see
leaders who did not necessarily know which way was up at some point in their lives. In
this way the course also foster humanity and humanism, and we cannot be doctors
without that.”
“YES YES YES. Leadership skills should def be taught to medical professionals. MDs are
kind, hard working, compassionate individuals but sometimes in my experience I have
seen that they do not take charge and try to make a change as much as their skills should
allow them to.”
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Future Iterations…
The Ideal:

full-year, independent course

integrated into curriculum

more of a t-group model
inter-disciplinary effort
between GSB and SoM


mandatory for all students
IHI Open School
Internal Medicine QI Elective
& A Hand Hygiene Project
Kambria Hooper, M.Ed.
Stephanie Carr, SMS III
IHI Open School
Internal Medicine QI Elective

Initiated in 2010
MED 344A: 6 unit, Any Quarter
Course Director: Clarence Braddock

Topics:

Mentored practice and growth in knowledge, skills, and attitudes in
quality improvement, patient safety, and organizational change

Directed readings, attend sessions with experienced QI champions

Learn about quality improvement projects and processes at Stanford
University

Participate in ongoing quality and patient safety activities within the
Department of Medicine and Stanford Hospital and Clinics

Design and begin a quality improvement/patient safety/organizational
change project

Develop a mentoring relationship with a QI champion who will serve as
a role model, mentor, and educator
IHI Open School
Stephanie Carr: Hand Hygiene – Follow the Leader?

Hypothesis:




To determine whether the hand hygiene habits of attending physicians or
the first person entering/exiting the patient room influenced the compliance
of other physician team members.
Method:

Four medical students individually shadowed physician teams
during morning rounds and measured hand hygiene compliance
Results:

Physician team members were more likely to wash their hands
upon entering and exiting patient rooms if their attendings washed
(75% v. 29%; p < 0.001)

Team members were also more likely to wash if the first person
entering/exiting washed (75% v. 31%; p < 0.001)
Conclusion:

Efforts to improve hand hygiene compliance should be directed
towards the attendings.
IHI Open School
Team Easy:
Incorporating Quality Improvement (QI)
into Stanford Medical Curricula
Shubha Bhat, SMS II
Natalia Leva, SMS II
Felipe Perez, SMS II
Julia Pederson, SMS II
Stephanie Smith, SMS II
IHI Open School
Team EASY: advocacy project
• Goal: Incorporate QI training into longitudinal
medical curriculum
• Process: Needs assessment with stakeholders
• Outcomes:
– “QI in Q6" pilot project, June 2010
– Recommendations for QI Core Competencies
– CCAP working group formed
• Next steps:
– Build support and interest among students and faculty
– Develop, pilot, and implement QI curriculum
IHI Open School
Team Easy Advocacy Project
IHI Open School
Team Easy: Stanford QI Training Environment
IHI Open School
IHI Open School
The Hospital Management
Collaborative
Promoting Patient Safety
Entrepreneurship
Nirav Kamdar, MD MPP
Department of Internal Medicine
IHI Open School
Education
SOM Centers
CERC
HMC Class
IHI
Breakthrough
Projects
Clinical
Effectiveness
Quality Working
Groups
QI Resident
Elective
Quality Council
QI Team
Challenge
QIPSC
IHI Open School
HMC: Goals






Create a health system modeling pipeline
Provide access to primary data
Provide exposure to real health management
problems
Provide a client experience with support
Increase academic leadership in quality
improvement
Increase resident publication opportunities
IHI Open School
HMC: What we need…



Single roundtable meeting with multidisciplinary
faculty
Direct interaction with CERC’s strategic plan
Organizational personnel to develop HMC course
and coordinate project teams
IHI Open School
Conclusions
IHI Open School
Conclusions




Align student initiatives with faculty/administration
projects already underway
Help facilitate a round table meeting with
multidisciplinary faculty and students*
Provide students with opportunities for
internships, rotations, and research in the QI/PS
space
Incorporate quality improvement and patient
safety as a core competency throughout
undergraduate and graduate medical education